甲氧西林耐药金黄色葡萄球菌对万古霉素药物敏感性试验的方法学比较  

Susceptibility of methicillin-resistant Staphylococcus aureus to vancomycin tested by three methods

作　　者：郭燕[1] 蒋晓飞[2] 朱德妹[1] 胡付品[1] 陈渊成[1] 吴湜[1] 杨洋[1] 

机构地区：[1]复旦大学附属华山医院抗生素研究所,卫生部抗生素临床药理重点实验室,上海200040 [2]复旦大学附属华山医院检验医学科,上海200040

出　　处：《中国感染与化疗杂志》2015年第4期341-344,共4页Chinese Journal of Infection and Chemotherapy

基　　金：国家科技部“重大新药创制”科技重大专项(2012ZX09303004-001);复旦大学附属华山医院2012年院内启动基金(院471)

摘　　要：目的比较不同药敏试验方法测定万古霉素对甲氧西林耐药金黄色葡萄球菌(MRSA)抗菌活性的影响。方法收集2013年临床分离的61株MRSA,采用微量肉汤稀释法、琼脂稀释法和E试验法对MRSA进行万古霉素药敏试验的测定。根据CLSI 2014年版标准进行结果判断。采用SPSS软件对3种药敏试验所得万古霉素最低抑菌浓度(MIC)值进行分析。结果MRSA对万古霉素的敏感率均为100%,未见万古霉素不敏感株。微量肉汤稀释法和琼脂稀释法测定万古霉素对MRSA的MIC50和MIC90值均为1 mg/L,采用E试验法测定的MIC50和MIC90值均为1.5 mg/L。3种药敏试验得到的MIC几何平均值分别为1.01(微量肉汤稀释法)、0.96(琼脂稀释法)和1.30(E试验法)。结论 3种药敏方法检测MRSA对万古霉素的敏感性结果虽一致,但由于万古霉素MIC值的细小差异在临床疗效上有着显著差异,故实验室为临床提供万古霉素药敏试验结果时,需要明确指出采用的具体药敏试验测定方法。Objective To investigate the effect of different testing methods on the susceptibility of methicillin-resistant Staphylococcus aureus （MRSA） to vaneomyein. Methods Sixty-one strains of MRSA were identified from clinical specimens in 2013. The minimum inhibitory concentrations （MICs） of MRSA strains to vancomycin were determined by broth microdilution, agar dilution and E-test methods, simultaneously. Results were analyzed according to the Clinical and Laboratory Standards Institute 2014 breakpoints. SPSS software was used to compare the MIC values obtained by three testing methods. Results All the MRSA strains （100%） were susceptible to vancomycin reported by any of the three testing methods. MIC50 and MIC90 values of vaneomycin against MRSA were 1 mg/L by broth microdilution and agar dilution methods, and 1.5 mg/L by E-test method. The geometric mean MIC value was 1.01 by broth microdilution method, 0. 96 by agar dilution method and 1.30 by E-test. Conclusions All MRSA strains are susceptible to vancomycin tested by any of the three testing methods. The testing method should be stated clearly when laboratory provides the result of vancomycin susceptibility.

关 键 词：甲氧西林耐药金黄色葡萄球菌 万古霉素 微量肉汤稀释法 琼脂稀释法 E试验法 药物敏感性 

分 类 号：R446.5[医药卫生—诊断学]